Speakers:

Kenny Gluck (K), Director of Operations:

It is with a deep feeling of sadness that Médecins Sans Frontières has decided to close all of its medical programmes in Afghanistan. This decision has come nearly two months after the killing of our five colleagues in a deliberate attack on June 2nd. The clearly marked MSF car was ambushed on a road in Badghis province. This targeted killing of five of our colleagues is unprecedented in the history of MSF, although we have been delivering medical humanitarian assistance in some of the most violent conflicts around the world over the last 30 years.

The lack of a framework for humanitarian action, the lack of respect for the safety of aid workers is seen in the governments' either unwillingness or inability to provide a credible investigation of this atrocity and to provide sufficient legal follow-up in terms of arrest and prosecution, of those who are guilty. The government investigators who are involved in following up this case have conveyed to us that they have credible evidence of the involvement of local commanders in Badghis province. But so far they have neither detained these people nor have they publicly denounced them and declared them to be fugitives. We think that the failure of a government follow-up in this case is a signal of an inadequate commitment to the safety of aid workers. On top of this, we are in a situation in which an alleged Taliban spokesperson has declared publicly that MSF will be a target in the future and made allegations that MSF staff have been working in the interest of the Americans. We fully reject these allegations - I think that Afghans throughout the country who have dealt with MSF medical staff over the last 24 years know full well that MSF is there solely in the interests of the health of their patients and has never accepted to be in the service of any military or political objectives. We have actively called for the space for independent humanitarian action to be respected by all parties in the conflict. These two facts - the government failure to arrest and to prosecute along with the threats of attacks on aid workers - has put us in a position where we feel that independent humanitarian action, which involves unarmed aid workers going into areas of conflict to provide aid, has become impossible. Aid work depends on the respect of armed actors for the notion that aid workers are not legitimate targets of violence and this framework is no longer present in Afghanistan.

Marine Buissonnière (M), Secretary General:

As Kenny Gluck just said, over the last 24 years MSF has provided health care throughout very difficult periods in Afghanistan regardless of which party or which group was in power. So it is with immense sadness that we take the decision to leave. We've come to the conclusion that we cannot sacrifice the security of our volunteers while we're being specifically targeted and while groups are seeking to target and kill humanitarian aid workers. But we also do know that ultimately those who will suffer are the sick and the needy who will need assistance in Afghanistan. The violence directed against humanitarian aid workers has come in a context where we feel that the US-backed coalition has contributed to the blurring of identities. The US-backed coalition has constantly sought to use and co-opt humanitarian assistance to build support for its military and political ambitions. And MSF denounces this attempt to co-opt humanitarian aid, to use humanitarian aid to win hearts and minds. By doing so, providing aid is no longer perceived as being a neutral and impartial act, and this is endangering humanitarian aid workers and this is jeopardizing the assistance to the Afghan people, the assistance which is needed. Some of you may know that in the month of May this year we addressed the coalition with the issue of the "famous" leaflets, with a picture of a young Afghan girl carrying a bag of wheat which was distributed throughout southern Afghanistan and which said that in order for the humanitarian assistance to continue they would need to pass on information about Taliban, Al Qaeda and Gulbaddin. So, all these elements are contributing to the deterioration of our space of assistance and has made it extremely difficult for us to pursue our activities. Humanitarian assistance is only possible when armed actors respect the safety of humanitarian actors; clearly in Afghanistan this is no longer the case. More than 30 aid workers have been killed since the beginning of the year. The killing of our own colleagues, together with the government's failure to arrest the culprits, and along with the false allegations of the Taliban have lead us to come to the regrettable conclusion that is no longer possible for us to work here, that the framework is no longer here. We of course hope that this will change, we hope that we will have positive signs, but for the time being, we have come to the conclusion that it is impossible for us to go on.

Until the assassination, MSF was working in 13 provinces throughout the country providing primary health care, working at clinic and hospital levels, working as well with tuberculosis, we had programs to reduce maternal mortality, we were involved in all these activities with about 1,400 of our Afghan colleagues and staff as well as about 80 MSF expatriates. We will complete the handover to the Ministry of Health (MoH) and NGOs in the weeks to come, and we will be completely closing our medical programs. As we leave Afghanistan, we leave it with a sense of mourning for the loss of our colleagues, but also with an immense sadness for the Afghan people that we leave behind and to whom we are still committed, and who we hope we will be able again to assist in the future. Thank you.

Questions & Answers

Q: Aren't there ways for you to stay in Afghanistan and deal with the security situation?

K:

When we're leaving Afghanistan, we're leaving because we feel there is not a framework in which we can put unarmed aid workers who are trying to provide assistance. We are scared that the lack of a government credible investigation and prosecution sends a message that it is acceptable to kill aid workers. And I think that is the key undermining of the aid effort. When we take the responsibility for placing volunteers in clinics and hospital, if we want to be doing that responsibly, we have to do that when there is a framework of respect for their safety. And that is what is undermined. We are here to provide health care for people in need. We can't be taking responsibility for an overall security situation. We're sending out a bunch of doctors and nurses, not people who are engaged in the creation of security.

M:

we go unarmed, we go unprotected, the only protection we have is the guarantee from the party in presence, from the power in presence that we are not a legitimate target, that we will not be attacked because they respect the work that we do. Because they perceive it as based on the needs of the people, as being independent and impartial, and at this stage obviously this is no longer possible. So, this is why we came to that conclusion.

Q: Can you explain the failure of the investigation?

Over the 24 years that we have worked here, we have developed extremely close relations with our colleagues in the Ministry of Health (MoH) and I think we have a good understanding of health care in Afghanistan. We have never pretended nor sought to understand how the security apparatus in Afghanistan has worked, so unfortunately we are at a loss. What we don't understand is when Afghan government investigators tell us that they know the identity of the criminals involved, they recognize that these are people possibly connected to local power structures. We don't understand why this cannot be followed up. So that is a question for us and I think it is a question you can legitimately pose to the law-enforcement bodies in Afghanistan.

Q: Obviously somebody attacked you because they had a certain image of MSF in connection to the US. Those people seem successful in driving you out of the country and could do the same with other organizations. Do you fear for other organizations?

K:

Absolutely, we fear for anybody in this context who is trying to provide assistance. And this is why we are calling on particularly the coalition to cease all activitiy which tries to put humanitarian aid in the service of their political and military objectives. For humanitarian assistance to be respected it has to have as its sole objective the saving of lives and the alleviation of suffering of people in need. And when armed actors try to convince others that we have other objectives, that we are interested in building up a particular political philosophy, we think that puts all aid workers in danger. As has the failure of the government investigation, so yes when we are taking the very difficult decision to no longer place our volunteers into Afghan villages, into Afghan clinics and hospitals, we're doing it because we think this framework of safety for aid workers is no longer there and I would be worried for all of my colleagues who are in other aid agencies who are trying to provide aid as well.

Q: Do you think that anyone else is going to follow your example?

M:

We have a sense that MSF's decisions will at least re-start a discussion or initiate some reconsideration of others' positions, but it's each agency's decision. We all act with our own principles and our own framework of security, and it's up to each to decide.

Q: Did the coalition respond to your concerns?

K:

MSF has been raising its concerns about the blurring of humanitarian and military objectives for over 3 years now. We have done this in meetings with Pentagon officials, we have done this in meetings with the British government, and we have done it directly on various occasions with embassies and with coalition officials. And we have made our concerns extremely clear at all levels. I find it hard to believe that the message hasn't gotten through. On many specific occasions we received promises from the coalition that this will no longer happen. When we complained about the leaflets, which were spread, linking collaboration with the military with humanitarian aid we were told again: "we're sorry, it won't happen again." But after how many years of lobbying them, are we still going to listen to the same answer? We've made these concerns clear in 2001 when Colin Powell called us "force multipliers" and "members of a team against terror." These are the kind of statements which completely undermine the notion of humanitarian assistance as an aid to people caught in conflict. It is a deliberate attempt to put us in one side of a conflict that we reject. And the coalition has come back to us and said "now, we recognize your concerns and we will work on it." but for us, after 3 years of raising these concerns that is insufficient.

Q: Do you know more about who is behind the killings, local commanders rather than the Taliban who claimed the attack?

K:

The people who have been involved in the investigation have told us that they do not believe that there is a Taliban link with the killings and that they were essentially "legal" militias which were involved, whether the army or the police I couldn't say.

Q: It's a difficult decision when you extract yourself from a situation like Afghanistan. How much of it is the result of no longer accepting the lines to be blurred and a will to make a political statement by leaving Afghanistan?

K:

No, before the assassination of our staff and before what we see as a failure of the government investigation and prosecution and the Taliban threats, we were not planning to leave Afghanistan. The blurring of humanitarian and military lines has been going on for a long time. We do believe it needs to be confronted and denounced. But it is principally the failure of armed actors to respect the safety of aid workers, which has been the motivation of our decision to leave now. It is unacceptable for us to put people on the ground in a condition in which aid workers are explicitly targeted. And that is unfortunately something for us which is very recent. It is unacceptable to put people on the ground when the people responsible for security fail to follow it up, because it sends a message to those who will kill aid workers that there will be impunity. And that's what we need to see changed before we come back.

Q: You have stayed in Afghanistan during the worst years, during the invasion. What does it say about the state of security that you have to pull out now?

M:

Until now, and until even very recently we were not specifically targeted and we never suffered such a loss, the scale of the one we faced today. In 1990, an MSF logistician was killed which lead to the suspension of MSF operations for some time. But never were we so specifically targeted, and never were we so specifically rejected by one of the parties. So, in that sense we do feel that the framework is no longer there and that is why we are pulling out. So that is where we have come today in our conclusion.

Q: Elections are due to take place in two months time. Should they be happening in this country?

K:

We have no idea whether elections should happen or not. We know that legal follow-up to murder of aid workers should happen. What are the conditions for elections? We have no idea.

Q: You say you have been presented with credible evidence that local commanders are involved, were you given any names? Are they police or army?

K:

They told us they have credible evidence. We don't participate in investigations. We are an organization that provides health care. We have no legal or detective division. We have left all of the investigations to the legal authorities, to the Afghan government. So, any questions about evidence you would have to turn to the Afghan government. It's their job to collect evidence and make the legal follow-up. We can't evaluate evidence. All they've told us is that suspects have been arrested and then released. They say they have credible evidence about the identity of the killers and of those who ordered it, and we are waiting for that to be put forward into real legal action.

Q: Will you consider returning to Afghanistan?

K:

We would be very anxious to return. Afghanistan is after so many years at war a country in which there are massive unmet medical needs. It is still a country with one of the highest rates of infant mortality in the world, it's still a country with one of the highest rates of maternal mortality in the world. This needs re-dress. So we would want to come back when we felt that there was a framework in which we can put our volunteers. We are not willing to turn into an armed agency of medical providers. We do believe in the humanitarian ideal that going unarmed into an area of conflict, trying to save lives, trying to alleviate suffering, is a reaffirmation of human dignity. And we insist on being able to do it in that framework. We think that the Afghan government has the capacity to take that step, to do their part in re-establishing that framework. We believe that the Taliban have their role in retracting the threats that have been made. That would be a step in re-establishing this framework. We also want the coalition to cease all activities which undermine humanitarian space. If we see progress on these fronts, we are absolutely committed to coming back to Afghanistan.

Q: Was MSF specifically targeted and what is the explanation for the government not following up?

K:

We have no sense that we were targeted because we were MSF. We just don't have any evidence about that. There were few NGOs providing health care in rural areas with expatriate personnel. We don't know if they were looking to kill aid workers, or expatriate aid workers or kill MSF. We simply don't know. We have no reason to believe that MSF was specifically targeted because we were MSF.

M:

When it comes to the explanation on the lack of follow-up, we were told that it was complex, that of course the case was still open and that it would take some time and that there were some obstacles. But we were not given specific elements. But these questions should be asked directly to the government and ministries involved.

Q: Is this the first time an attack of this kind occurred?

K:

It's the second time that we've had fatalities in Afghanistan. The previous case being in 1990 in Badakhshan province where Frédéric Galland was killed. And we've had people assassinated in other countries. It is the most horrible thing for us to endure. We do have a belief that humanitarian aid, which is an ethic of going into a conflict and trying to provide assistance or going into a population which is abused and neglected, a population which is hated and trying to help them, we accept that this has inherent risks. We don't think that you can provide humanitarian assistance in a way which is entirely safe. And all our volunteers go through a process in which they say: "Yes, I accept risk." By going to Somalia, to Congo or Afghanistan, they accept risks on their shoulders and that's part of their engagement with the people who are facing far, far greater risks. That is what we do and we can't eliminate that. But we do think that we have to ask a certain framework of safety for us to be able to work, and in Afghanistan at the moment, with the killings, with the lack of the governmental follow-up and the explicit threats to MSF this isn't there.

Q: Are you talking to the Taliban?

K:

We certainly believe that we have to negotiate our access with all armed actors, and that includes the Taliban. And we will seek to speak to them in order to reaffirm who we are, in order to reaffirm that our objectives are about providing health care to people in need and that we are not here with any other objectives. We don't believe it is useful or practical to go into the details of how and when we will discuss with them.

Q: Apparently, the government has said that it will attempt to solve the case. What would you need to see happen in order to stay in Afghanistan?

M:

We welcome the news that they are still pursuing and continuing their efforts to try to bring the killers to justice and to try to have a proper legal follow-up. At this stage though we haven't yet seen any of these concrete realizations. We do wait for further concrete conclusions to the case before we can look into working in Afghanistan again.

Q: Is there any last-minute effort by the government?

M:

The government and the officials who we have talked to are sad to see us leave. It's obvious that it is not with joy that they are welcoming MSF's departure. They do understand and respect the reasons of our departure, but of course they are eager to see us back as much as we are to come back. I would say it is upon them to show us there is space here for us to work and to show that the framework which we need is here. So there are ongoing discussions, there has been information given to us - no promises - that things were still moving ahead in the investigation and in the proceedings. We are still waiting to see the result.

K:

We have deep friendships and long-standing collegial relations with a lot of people in the Afghan government, most particularly the MoH. And I know they mourned with us when our colleagues were killed, and of course they want us back, and of course we want to work with them. We've worked with many of these people for 24 years, but they do understand our position. Even the families of the people who where killed, have asked us: "please, continue providing aid. This is what our family members had dedicated their lives to, please don't stop." And I think that in the MoH it is a similar reaction. But that is the emotional side which we all feel. You have an ethic for caring for people in need, and we all want to do that. But all of the people we have spoken to in the government and outside, have said: "yes, we do understand that your responsibility for your volunteers, for your staff. We will do our best to repair that so that you can come back."

Q: When will you leave Afghanistan?

K:

We are going to be handing over programs to the MoH and to other NGOs in the coming weeks and people will be gradually leaving throughout that period.

Q: Do you see this as a problem that goes beyond Afghanistan? Given the climate of military intervention and the enthusiasm for humanitarian aid, do you see this as a problem that is going to be wider than Afghanistan?

M:

There is definitely a trend we see that could be wider than Afghanistan, wherever you have coalition forces, wherever you have actors that are mixing mandates, that have mixed mandates by definition, such as UNAMA or other UN agencies, that are both political and humanitarian, you will definitely continue seeing a blurring of the identities and therefore a danger for impartial, neutral humanitarian action, yes definitely beyond the borders of Afghanistan.

Q: Can you clarify, there seem to be two reasons why you are leaving. Firstly, the blurring of the lines. Secondly, the lack of follow-up by the Afghan government. If tomorrow the government would come back to you saying: "we found the guy and we're holding him accountable," would you consider coming back in or would you need the other part of the puzzle to be mended as well?

K:

You left one out. The primary reasons for our departure from Afghanistan are: the failure of the government investigation which we think sends a message of impunity for the killing of aid workers. Second, we have a threat from an alleged Taliban spokesperson who has said that aid workers - MSF - will be explicitedly targeted. Those are the primary two reasons. The undermining of humanitarian space by the coalition corrupts the environment for humanitarian aid, but it is the first two that need to change first and foremost for us to consider a return to Afghanistan. However, we will continue, inside and outside of Afghanistan, to pressure the coalition to stop actions that undermine humanitarian space and we will continue to do this with groups like the UN and other NGOs who mix political and humanitarian objectives. We believe this is part of the problem.

Q: Besides the leaflet example can you give another concrete example of the blurring of the lines?

K:

In addition to the leaflets, in addition to statements by government officials such as Colin Powell - I don't how the media works but he seems to get more press attention than we do - so these are statements that resonate quite widely and which everybody has heard of. We've also seen military people with weapons in civilian clothing, in white cars going about providing health care. If you ask Afghans to try to distinguish between two modes of engagement - military and humanitarian - how can you expect them to? I think these are the kind of specific examples which undermine the ability of Afghans to distinguish. And it is fundamental in a war to be able to distinguish between legitimate targets of violence and illegitimate targets of violence. We want a volunteer doctor who goes off to treat tuberculosis, unarmed and without any armed escort, as we work, to be able to work in an environment where everybody knows he or she is not a legitimate target, but an aid worker. And that's an ethic we have to restore in Afghanistan.

Q: Are they providing health care in certain areas because organizations such as MSF don't have a presence there?

K:

No, actually they have come into some of our own clinics, and when we said: "Why, if we are already here, why are you here?" So we don't know where they are doing this - again our job is not to investigate coalition activities - we only know about it when they bump into us where we are.

Q: What will be happening to your programs?

M:

All of the programs are presently being handed over, either to the MoH or to NGOs which are committed to pursue them. Of course, we fear that at least for some of them, and temporarily, there will be a loss of quality and that the MoH might lack some of the resources to pursue some, but we try our best to hand over the programs in a way that would not impact too negatively on the Afghan population. That was the objective.

K:

But in the end, our programs are organized to save lives and I think that the lack of some of this intervention will have consequences, and certainly our staff who we had to pull out - and we had to fight with our staff to get them out - some of them said: "let us stay." And in particular there was a German obstetrician to whom we said: "No, you can't stay." She was in tears knowing that she wasn't going to be able to provide aid to her patients who would be delivering soon. That is the sadness, again not only for the Afghans but even for our medical staff who were very committed to these programs and to their individual patients. And that's what they had to suffer through.

Q: You're one of the most prominent NGOs who work here, and to a large extent MSF has built its profile in Afghanistan. How will your decision impact on the humanitarian presence here?

K:

I'm not sure if we have built our profile through Afghanistan, we certainly have learned a lot about our identity, we've learned a lot about neutrality, we've learned a lot about the need to have a purely humanitarian identity in Afghanistan through the years, because it is one of our long-term engagements. We have to take the decisions, which we think are responsible for our staff, for our volunteers, and in the end for the clinics and hospitals that we work in. That's our primary responsibility. We don't want to take decisions for other NGOs. Every NGO has a responsibility to look at the situation, to look at their engagement with people in Afghanistan, with their patients, with the people they work with and with the environment and decide for themselves what is ethical, what has impact and what is a humanitarian engagement. And then they have to take the decisions, which are consequent to that analysis. And we really are telling all of the other agencies, and we have met with many of them in this time: "Please, take your own decision. Please don't let us take decisions for you."

Q: All of your local staff, will they have guaranteed employment with the MoH or other NGOs?

K: Inevitably some will be laid off. We are taking a lot of effort to try to arrange them jobs with other agencies, whether it be part of the same program or not. We are trying to help them in this transition with severance packages and so on, but we can't guarantee them a livelihood after we leave. And that's painful. Often these are people who have been with us through very, very difficult situations, through the wars that have been here, who have interpreted Afghan society for us, invited us into their homes and villages, and taken care of us. And it is very difficult to say goodbye to them, but we will certainly do all we can so that they can have that transition. But I'm not sure we're gonna be a 100% successful.